| Health Gorilla Medical | |
|
2242 Camden Ave Ste 204 San Jose CA 95124-2029 | |
| (650) 383-4768 | |
| (650) 249-1364 |
| Full Name | Health Gorilla Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 2242 Camden Ave Ste 204, San Jose, California |
| Authorized Official Name and Position | Steve Yaskin (CEO) |
| Authorized Official Contact | 6502721218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Gorilla Medical 228 Hamilton Ave Fl 3 Palo Alto CA 94301-2583 Ph: (844) 446-7455 | Health Gorilla Medical 2242 Camden Ave Ste 204 San Jose CA 95124-2029 Ph: (650) 383-4768 |
| NPI Number | 1740855758 |
|---|---|
| Provider Enumeration Date | 05/21/2021 |
| Last Update Date | 08/24/2021 |
| Medicare PECOS PAC ID | 3779989728 |
|---|---|
| Medicare Enrollment ID | O20210831001474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740855758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Patricia Roukee Sitnitsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790896231 PECOS PAC ID: 3971547829 Enrollment ID: I20050613000617 |
| Provider Name | Inna Yaskin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316965353 PECOS PAC ID: 7810940707 Enrollment ID: I20110301001103 |
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